Clostridium difficile has been isolated from food animals and meat, specially ground pork and ground beef. The recovered isolates were closely related to C. difficile human strains, indicating that animals and food are possible transmission routes of human C. difficile infection. The main objective of this study was to characterize C. difficile isolates from retail meat and to compare with human isolates recovered from hospital patients in Belgium. Raw meat (beef and pork) was obtained from the retail trade. C. difficile was recovered from 2.3% of the beef samples and from 4.7% of the pork samples. A total of 4 different PCR-ribotypes were identified with a large percentage of types 078 and 014. Resistance to moxifloxacin and erythromycin was detected. The multi-locus sequence typing (MLST) analysis showed that meat and human isolates cluster in the same lineage. This study reveals the presence of toxigenic C. difficile in retail meat in Belgium with predominance PCR-ribotypes 078 and 014, which are among the four most prevalent ribotypes of C. difficile isolated from humans in Europe. [less ▲]

The Peltigera neopolydactyla/dolichorhiza complex is broadly distributed, growing in boreal and temperate regions from northern Norway to southern Chile, as well as in tropical mountains. Observed ... [more ▼]

The Peltigera neopolydactyla/dolichorhiza complex is broadly distributed, growing in boreal and temperate regions from northern Norway to southern Chile, as well as in tropical mountains. Observed morphotype and chemotype variation within this complex suggested the presence of multiple undescribed species. We inferred the phylogeny of Peltigera section Polydactylon with a special focus on the Peltigera neopolydactyla/dolichorhiza complex to determine the full breadth of this species complex, and to assess if taxa from different parts of the worlds but with similar morphological features share a most recent common ancestor. About 525 ITS sequences representing 104 distinct haplotypes were generated for representatives of Peltigera section Polydactylon. We selected a representative of each broadly defined phylotype for which three protein-coding loci: RPB1.1, b-tubulin and EFT2.1 were sequenced. Each of the three protein coding loci provided equivalent or more resolution and support than the ITS locus. The greatest proportion of significantly supported nodes across the tree resulted from β-tubulin alone. Many specimens identified as P. neopolydactyla and P. dolichorhiza are placed outside of this species complex. As currently defined both species represent polyphyletic assemblages of taxa including several potentially undescribed species. Our phylogenies suggest the presence of putatively new species within several complexes across the section. [less ▲]

The European Neurological Network is a European Economic Community supported project. The purpose of the project was to develop a multimedia educational tool for general practitioners in order to improve ... [more ▼]

The European Neurological Network is a European Economic Community supported project. The purpose of the project was to develop a multimedia educational tool for general practitioners in order to improve their management of sleep disorders, epilepsy and headache. The project involves approximately one hundred engineers and physicians from Belgium, Denmark, England, Finland, France, Germany, Italy, Portugal and Spain. This paper concerns the multimedia educational tool on headache. The system consists of five different modules, i.e. classification, clinical data, headache tutorial, diagnostic headache diary and nomenclature. It is possible to move between the modules both vertically and horizontally. The headache classification of the International Headache Society is provided in full text as a work of reference. This classification is used world wide and has been adopted by International Classification of Diseases 10 Neurological Adaptation (ICD-10 NA) and the World Health Organisation. The clinical data concentrate on migraine and tension-type headache, the two most common headache disorders, but data on familial hemiplegic migraine, cluster headache, drug-induced headache and secondary headaches are also available. The headache tutorial consists of case records that the user can test their diagnostic abilities on. The diagnostic headache diary is an expert system on headache diagnostics. It can be filled in during a consultation in order to provide the headache diagnosis or it can be printed and used by the headache patient to record headache attacks and medicine consumption. The nomenclature module provides an explanation of words and expressions used in the system. [less ▲]

We illustrate how the ISO E-LOTOS language can be used to describe an ODP multicast multimedia binding object of some complexity. The timing features of the language are briefly recalled, and play a major ... [more ▼]

We illustrate how the ISO E-LOTOS language can be used to describe an ODP multicast multimedia binding object of some complexity. The timing features of the language are briefly recalled, and play a major role in the description of the example, but many other features of E-LOTOS are also very useful to obtain a more modular and more readable specification. Users familiar with LOTOS will also learn how some E-LOTOS features can advantageously replace the traditional LOTOS ones. [less ▲]

Motivation – To analyse how Augmented Reality associated to video may affect collaborative design and multimodal interactions. Research approach – An exploratory study that aims to compare 2 pairs of last ... [more ▼]

Motivation – To analyse how Augmented Reality associated to video may affect collaborative design and multimodal interactions. Research approach – An exploratory study that aims to compare 2 pairs of last year students in co-presence with 1 distant pair. Each pair had to solve an architectural design problem. Collected video has been coded with a systematic method of protocol analysis. Findings/Design – When using an AR desktop-based CAD, distance may not affect the design process itself whereas it may affect how the process is distributed across the various modalities of collaboration. Furthermore, collaborating and architectural experiences influence collaboration and/or design. Research limitations/Implications – Only 3 pairs of students participated in the study resulting in 12 h of video protocol, which limits generalisation of the findings. Originality/Value – The research makes a contribution in providing a detailed view on how external (e.g. situation, technology) and individual factors may affect the activity of collaborative design. Furthermore, we propose a coding method usable beyond design in a wide range of collaborative activities to underline how they are affected by technology and other situational constraints. Take away message – Technology constraints as well as personnal characteristics of designers result in designing with specific forms of multimodal collaboration. [less ▲]

Ambulation measures are being increasingly recognized as highly relevant to the quantification of multiple sclerosis (MS) severity and response to treatment. Feet paths are highly informative for gait ... [more ▼]

Ambulation measures are being increasingly recognized as highly relevant to the quantification of multiple sclerosis (MS) severity and response to treatment. Feet paths are highly informative for gait analysis and we have recently designed a new system, which captures the position of the feet in real time. We use several range laser scanners (RLS) to analyze a horizontal slice of the scene in which each foot is considered as a point, and the vertical movements are ignored. Neat ambulation measures may be easily extracted such as walking speed, distance between feet over time, swing phase duration, and gait asymmetry in specific settings of walking recommendations. Our RLS platform is much cheaper than existing sensor-based and motion capture systems and may be more convenient for the development of multicentric clinical trials settings since patients can be easily and rapidly assessed without tags or sensors in the hallway of an outpatient clinic. We use 4 BEA LZR-i100 RLS arranged in a corridor of at least 10m long and 4m width, devoid of obstacle. The scanned plane is chosen to be located at 15 cm above the floor, which is right above the tibio-tarsal joint of the ankle in a barefoot configuration for adult individuals in stance phase. We expect further studies to validate and empower the meaning of non-intrusive RLS-derived gait measures that should pave the ground for major improvements in the way we will assess the efficacy of disease-modifying treatments (DMTs), physical therapy and symptomatic interventions on walking impairment, ataxia and fatigability in MS. RLS-derived gait measures may also reveal to be crucial in the near future for the development of treatments that would specifically target progressive forms of MS. [less ▲]

Beside behavioral assessment of patients with disorders of consciousness, neuroimaging modalities may offer objective paraclinical markers important for diagnosis and prognosis. They provide information on the structural location and extent of brain lesions (e.g., morphometric MRI and diffusion tensor imaging (DTI-MRI) assessing structural connectivity) but also their functional impact (e.g., metabolic FDG-PET, hemodynamic fMRI, and EEG measurements obtained in "resting state" conditions). We here illustrate the role of multimodal imaging in severe brain injury, presenting a patient in unresponsive wakefulness syndrome (UWS; i.e., vegetative state, VS) and in a "fluctuating" minimally conscious state (MCS). In both cases, resting state FDG-PET, fMRI, and EEG showed a functionally preserved right hemisphere, while DTI showed underlying differences in structural connectivity highlighting the complementarities of these neuroimaging methods in the study of disorders of consciousness. [less ▲]

Introduction: The aim of this study is to analyze the transfusion rates of cardiac surgery patients in a single centre following an in-house strategy of blood conservation. Methods: The data of all adult ... [more ▼]

Introduction: The aim of this study is to analyze the transfusion rates of cardiac surgery patients in a single centre following an in-house strategy of blood conservation. Methods: The data of all adult patients undergoing normothermic cardiac surgery with cardiopulmonary bypass (CPB) over a 1 year period were retrospectively collected (n=491). Management protocols were described. The transfusion rates of allogeneic blood components were recorded: red blood cells (RBC), fresh frozen plasma (FFP) and platelets (PT), as well as the number of units transfused. The timing of transfusion was categorized: during CPB (peroperative period), within the first 48 postoperative hours after wean out CPB (early postoperative period) and during the hospitalisation from surgery until discharge (hospitalisation). The hematocrit values were recorded during CPB, 10 minutes after wean out CPB, after the first 48 postoperative hours and at discharge from hospital. Results: Two hundred and forty-eight patients (50%) received an allogeneic blood component transfusion during hospitalisation. One hundred and twenty-one patients (25%) received RBC during the operative period; the median of units transfused was 2(1-2).The lowest hematocrit value during CPB was 21(19-24) % in median. A cell salvage device was used in each case: the median volume of washed red blood cells transfused was 678(512-891) mL. The median hematocrit value after CPB was 23(21-25) %. One hundred and sixty-five patients (34%) were transfused in the early postoperative period: 27% received RBC, 18% received FFP and 18% received PT. The median of units transfused was 2(1-3) for RBC, 4(2-6) for FFP and 1(1-2) for PT. The median hematocrit value after 48 hours was 32(29-34) % and 32(30-35) % at discharge. Conclusion: The transfusion rates observed in this series are relatively high compared with the literature. Improvements will be made in our practice and protocols management in order to decrease the need of transfusion. This detailed audit of the transfusion practices in our cardiac surgery centre would be helpful to value the effectiveness of further improvements. [less ▲]

Lung cancer is among the most common and lethal cancers around the world. Most lung cancers are directly attributed to smoking. Common histologic subtypes of lung carcinomas are squamous cell carcinoma ... [more ▼]

Lung cancer is among the most common and lethal cancers around the world. Most lung cancers are directly attributed to smoking. Common histologic subtypes of lung carcinomas are squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. These carcinomas have similar presentations and are primarily treated surgically. Hence, these are usually classified as non-small cell lung carcinoma. Small cell lung carcinoma is an aggressive neuroendocrine tumor with a generally poor prognosis. It usually presents with massive mediastinal lymphadenopathy and widespread metastases at initial diagnosis, and is usually treated with chemotherapy and radiotherapy; surgery has little role.Cough, dyspnea and hemoptysis are the consistent clinical features of most lung cancers. Advances tumors with pleural, chest wall, or mediastinal invasion produce a variety of additional clinical features such as chest pain, brachial plexus neuropathy, Horner syndrome, phrenic or recurrent laryngeal nerve palsy, dysphagia, or superior vena cava syndrome. Sone of the lung cancers are detected as small pulmonary nodules in asymptomatic individuals. [less ▲]

The monofunctional penicillin-binding DD-peptidases and penicillin-hydrolyzing serine beta-lactamases diverged from a common ancestor by the acquisition of structural changes in the polypeptide chain ... [more ▼]

The monofunctional penicillin-binding DD-peptidases and penicillin-hydrolyzing serine beta-lactamases diverged from a common ancestor by the acquisition of structural changes in the polypeptide chain while retaining the same folding, three-motif amino acid sequence signature, serine-assisted catalytic mechanism, and active-site topology. Fusion events gave rise to multimodular penicillin-binding proteins (PBPs). The acyl serine transferase penicillin-binding (PB) module possesses the three active-site defining motifs of the superfamily; it is linked to the carboxy end of a non-penicillin-binding (n-PB) module through a conserved fusion site; the two modules form a single polypeptide chain which folds on the exterior of the plasma membrane and is anchored by a transmembrane spanner; and the full-size PBPs cluster into two classes, A and B. In the class A PBPs, the n-PB modules are a continuum of diverging sequences; they possess a five-motif amino acid sequence signature, and conserved dicarboxylic amino acid residues are probably elements of the glycosyl transferase catalytic center. The PB modules fall into five subclasses: A1 and A2 in gram-negative bacteria and A3, A4, and A5 in gram-positive bacteria. The full-size class A PBPs combine the required enzymatic activities for peptidoglycan assembly from lipid-transported disaccharide-peptide units and almost certainly prescribe different, PB-module specific traits in peptidoglycan cross-linking. In the class B PBPs, the PB and n-PB modules cluster in a concerted manner. A PB module of subclass B2 or B3 is linked to an n-PB module of subclass B2 or B3 in gram-negative bacteria, and a PB module of subclass B1, B4, or B5 is linked to an n-PB module of subclass B1, B4, or B5 in gram-positive bacteria. Class B PBPs are involved in cell morphogenesis. The three motifs borne by the n-PB modules are probably sites for module-module interaction and the polypeptide stretches which extend between motifs 1 and 2 are sites for protein-protein interaction. The full-size class B PBPs are an assortment of orthologs and paralogs, which prescribe traits as complex as wall expansion and septum formation. PBPs of subclass B1 are unique to gram-positive bacteria. They are not essential, but they represent an important mechanism of resistance to penicillin among the enterococci and staphylococci. Natural evolution and PBP- and beta-lactamase-mediated resistance show that the ability of the catalytic centers to adapt their properties to new situations is limitless. Studies of the reaction pathways by using the methods of quantum chemistry suggest that resistance to penicillin is a road of no return. [less ▲]